Efficacy and safety of different Janus kinase inhibitors combined with methotrexate for the treatment of rheumatoid arthritis: a single-center randomized trial

Abstract Objective To compare the efficacy and safety between baricitinib (BARI) and tofacitinib (TOFA) for the treatment of the rheumatoid arthritis (RA) patients receiving methotrexate (MTX) in clinical practice. Methods This retrospective study recruited 179 RA patients treated with BARI (2-4 mg/d) or TOFA (10 mg/d) at The First Affiliated Hospital of Guangxi Medical University from September 2019 to January 2022. The rate of low disease activity (LDA) was used as the primary end point. Secondary end points included the Disease Activity Scale-28 (DAS-28)-C-reactive protein (CRP); the rate of DAS28-CRP remission; visual analogue scale (VAS) for pain, swollen joint, and tender joint counts; and adverse events at the 6-month follow-up. Several factors affecting LDA achievement were also analyzed. Results Seventy-four patients were treated with BARI and 105 were treated with TOFA, including 83.24% females, with a median (IQR) age of 56.0 (53.0-56.0) years old and disease duration of 12.0 (6.0-12.0) months. There was no difference of the rate of LDA between the BARI and TOFA treatment groups. All disease indices in the two groups were significantly improved, including a significantly lower VAS in the BARI group (P < 0.05), reflecting the drug efficacy after 1 and 6 months of treatment. The incidence of adverse reactions was similar in these two groups. Conclusion The treatment efficacy and safety of BARI and TOFA in the RA patients were similar, but BARI was more effective in pain relief than TOFA. An older baseline age was more likely to achieve LDA in the BARI group, while a low baseline erythrocyte sedimentation rate (ESR) was more likely to achieve LDA in the TOFA group.

Quantitative evaluation of apparent diffusion coefficient and renal volume on fetal renal development and renal disease / 中华围产医学杂志

Objective:To explore the value of apparent diffusion coefficient (ADC) and renal volume in assessing fetal kidney development and disease.Methods:From January 2016 to October 2020, 84 fetuses with congenital anomalies of the kidney and urinary tract (CAKUT) were identified with MRI (CAKUT group), and 97 fetuses with no significant abnormalities on MRI or postnatal follow-up (control group) from the Obstetrics and Gynecology Hospital of Fudan University were enrolled and analyzed retrospectively. ADC value and renal volume were measured to compare the two groups, and the relationship was analyzed between these two parameters in the control group with gestational age, location (left or right kidney), and fetal gender. Two independent or paired sample t-tests, and linear correlation analyses, were adopted for the statistical analysis. Results:(1) There were 84 pregnant women in the CAKUT group, including a twin pregnancy, with an average age of (29±4) years old, ranging from 21 to 39 years old. The gestational age at MRI was (26±4) weeks with a range of 21-34 weeks. Of the 85 fetuses, 52 were male (61.2%), and 33 were female (38.8%). The polycystic dysplastic kidney was found in 32 cases (37.6%), hydronephrosis in 29 cases (34.1%), and an isolated kidney in 24 cases (28.2%). There were 97 singleton pregnancies in the control group, including 45 (46.4%) male and 52 (53.6%) female fetuses. The average maternal age was (30±5) years old, with a range of 19-41 years old, and the gestational week at MRI was (27±4) weeks, with a range of 21-34 weeks. (2) In the control group, the mean ADC value and renal volume were (1.255±0.112)×10 －3 mm2/s and (4 747±2 479) mm 3, which were negatively ( R 2=0.30, P<0.01) and positively correlated ( R 2=0.80, P<0.01) with the gestational age, respectively. There was no significant difference between ADC value and renal volume between different fetal gender in the control group. (3) The ADC value and the renal volume of fetuses with polycystic dysplastic kidney [(1.720±0.200) ×10 －3 mm2/s and (8 154±8 337) mm 3] were higher than those in the control group ( t=－13.11 and－3.08, P<0.001 and P=0.004). Compared with the control group, ADC of fetuses with hydronephrosis [(1.333±0.171) ×10 －3 mm2/s] was higher ( t=－3.90, P<0.001); and the renal volume [(7 201±4 460) mm 3] was larger but without statistical significance. The fetuses with an isolated kidney had an increasing trend in renal volume [(5 239±4 244) mm 3] and a decreasing trend in the ADC value [(1.239±0.125) ×10 －3 mm2/s] when compared with the normal fetuses, but neither difference was significant. Conclusions:In normal fetuses, the ADC value decreases, and the renal volume increases with the gestational age. Fetuses with CAKUT may have a larger kidney than normal.

Construction and application of central monitoring system of hospital ward monitor / 中华医院管理杂志

The authors introduced the construction of the central monitoring system of bedside monitor in a hospital, and introduced its software and hardware design scheme and function in detail. The implementation of the system guaranteed the medical safety, reduced the workload of medical staff, improved the work efficiency, and had the characteristics of low cost and practicability.

Distribution characteristics of Chinese medicine resources in Turpan Basin, Xinjiang / 中国中药杂志

Based on the results of the fourth national survey of traditional Chinese medicine resources in Turpan city, Xinjiang, this study counted the types of traditional Chinese medicine resources in Turpan Basin. The spatial distribution differences of traditional Chinese medicine resources in Turpan Basin of Xinjiang were analyzed by using grid technology, trend surface analysis, global spatial autocorrelation analysis, and local spatial autocorrelation analysis, so as to clarify the overall change trend and aggregation degree of traditional Chinese medicine resources in Turpan Basin in horizontal and vertical directions. The results showed the following: in the horizontal direction, the species richness of traditional Chinese medicine resources in the central part of Turpan Basin was high, and there were great differences in the species richness of traditional Chinese medicine resources in Turpan Basin under different grid sizes. The spatial scale effect of the richness of traditional Chinese medicine resources in Turpan Basin is obvious. Among them, under the 30 km×30 km scale, the richness of the types of Chinese medicine resources shows a high spatial correlation, and the richness of the types of Chinese medicine resources at 5 km×5 km scale presents a near random distribution state, and the richness of the types of Chinese medicine resources at 80, 90, and 100 km scale sits negatively related. Vertical direction, Chinese medicine resources appear rich at the range of-154-150 m and 900-1 050 m following by range of 1 050-1 200 m.

Comparison of Effect of Fine Powder and Ultrafine Powder of Dendrobium nobile Stem on Intestinal Transporters of Rats / 中国实验方剂学杂志

Objective:To compare the contents of alkaloids from fine and ultrafine powder of Dendrobium nobile stem in rat plasma,and investigate the effect of D. nobile stem with different particle sizes on gene expression of intestinal transporters. Method:Rats were randomly divided into the blank group,fine powder group of D. nobile stem(0.25 g·kg-1) and ultrafine powder group of D. nobile stem(0.25 g·kg-1).The rats were gavaged every 6 h for 5 days.The samples of rat plasma and small intestine were collected.The plasma samples were detected with UPLC-MS.The chromatography separation was performed on a Hypersil Gold C18 column(2.1 mm×150 mm,1.9 μm) with acetonitrile-0.1%formic acid solution as mobile phase for gradient elution.Electrospray ionization (ESI) was applied and operated in positive ion mode.The mRNA expression of multidrug resistance protein 1(MDR1),oligopeptide transporter protein 1(PEPT1),organic cation transporter protein 2(OCT2),breast cancer resistance protein 1(BCRP1),monocarboxylate transport protein 1(MCT1) and multidrug resistance related protein 2(MRP2) in small intestine were quantified by real time fluorescence quantitative polymerase chain reaction. Result:After intragastric administration of fine and ultrafine powder of D. nobile stem,dendrobine,mubironine B and dendramine could be detected in rat plasma.The contents of dendrobine and dendramine in the ultrafine powder group were significantly higher than that in the fine powder group(PD. nobile stem(PPD. nobile stem(PConclusion:Compared with the fine powder group of D. nobile stem,the plasma concentrations of dendrobine and dendramine in the ultrafine powder group are significantly increased,it may be related to the intestinal transporters of MDR1 and BCRP1.These results can provide experimental basis for selecting particle size of D. nobile stem.

Chemical constituents from green walnut husks and their antitumor activity in vitro / 中国中药杂志

Fourteen chemical constituents, including 5-hydroxy-4-methoxy-1-tetralone(1), 4,8-dihydroxy-1-tetralone(2), 4,5-dihydroxy-α-tetralone(3), blumenol B(4), dehydrovomifoliol(5), megastigm-5-ene-3,9-diol(6), juglanin B(7), blumenol C(8), loliolide(9), oleracone B(10), syringarsinol(11), pinoresinol(12), methyl 4-hydroxy-3-methoxybenzoate(13), and isovanillic acid(14), were isolated from the dichloromethane fraction of 95% methanol extract of green walnut husks by silica gel and MCI column chromatography, and Pre-HPLC. Their structures were determined by spectroscopic methods, such as NMR, MS and so on. Among them, compounds 1, 4-6, 8-13 were isolated from the green walnut husks for the first time, and compounds 4-6, 8, 10, 12, 13 were isolated from the Juglans genus for the first time. All of isolates were detected their inhibitory activities against HeLa, HGC-27 and Ht-29 cell lines by the MTT assay. The result showed that compounds 2, 3, 7, 9 and 11 exhibited inhibitory activity against the tested cell line. The IC_(50) of 7 were 26.5, 9.0, 25.4 μmol·L~(-1), respectively.

A new sesquiterpenoid from the roots of Stelleropsis tianschanica / 药学学报

Three sesquiterpenoids were isolated from the dichloromethane extract of the roots of Stelleropsis tianschanica Pobed through a combination of various chromatographic approaches, including silica gel, Sephadex LH-20, reverse phase C18 and so on. On the basis of spectroscopic data analysis, they were identified as (+)-guaia-l(10),ll-dien-9-one-5α-hydroxy (1), 4β,5βH-guai-9,7(11)-dien-12,8-olide-1α,8α-diol (2), 4α,5βHguai-9,7(11)-dien-12,8-olide-1α,8α-diol (3). The compound 1 is a new sesquiterpenoid, and the compound 3 was isolated for the first time from the genus Stelleropsis.

Chemical constituents from plant of Stelleropsis tianschanica (II) / 中草药

Objective: To further study the chemical constituents of Stelleropsis tianschanica. Methods: The constituents were isolated and purified by silica gel chromatography repeatedly, and the structures were identified by spectra analysis and chemical methods. Results: Twelve compounds including five lignans and three diphenylpentane derivatives were obtained, and named as kusunokinin (1), pluviatolide (2), dibutyl phthalate (3), dipropyl phtalate (4), p-dihydroxybenzene (5), daphneolon (6), 2(S)- hydroxy-1-(4-hydroxy phenyl)-5-phenyl-1-pentanone (7), (2R,3R)-1,5-diphenylpentane-2,3-diol (8). lariciresinol (9), isolariciresinol (10), matairesinol (11), and 4α,5βH-guai-9,7(11)-dien-12,8-olide-12,8α-diol (12). Conclusion: Compounds 1-12 are all obtained from the plant of S. tianschanica and the genus Stelleropsis Pobed. for the first time.

Chemical constituents from roots of Stelleropsis tianschanica / 中国中药杂志

The constituents from 95% ethanol extract of the roots of Stelleropsis tianschanica were purified by column chromatography techniques, leading to the isolation of 17 compounds. Their structures were elucidated by spectroscopic dataas 5'-methoxy lariciresinol(1), pinoresinol(2), daphnoretin(3), acutissimalignan B(4),(+)-secoisolariciresinol(5),(+)-epipinoresinol(6), 7-methyi-daphnoretin(7), thero-8S-7-methoxysyringylglycerol(8), 1-O-methyl-guaiacylglycerol(9), 2R-22'-ferulic acid ester-2,3-dihydroxypropyl ester(10), vesiculosin(11), 4β,5βH-guai-9,7(11)-dien-12,8-olide-1α,8α-diol(12),(-)-nortrachelogenin(13), 4α,5βH-guai-9,7(11)-dien-12,8-olide-1α,8α-diol(14), matairesinol(15), lariciresinol(16)and isolariciresinol(17). Among them, compounds 1-13 wereobtained for the first time fromthe genus Stelleropsis. Compounds 3, 7, 10-14 were tested for their activation of orphan nuclear receptor TR3 with the immunofluorescence technology in 50 μmol•L⁻¹. The results showed that compound 10 displayed moderate activity with the activity ratio of 76.38%, and the others were only about 50.0%.

Chemical constituents from plant of Stelleropsis tianschanica / 中草药

Objective: To study the chemical constituents from the arerial parts of Stelleropsis tianschanica. Methods: The constituents were isolated and purified by silica gel chromatography repeatedly, and the structures were identified by spectra analysis and chemical methods. Results: Thirteen compounds were isolated from S. tianschanica and the structures were identified as (+)-pinoresinol (1), (-)-pinoresinol (2), 3'-desmethylarctigenin (3), arctigenin (4), pluviatolide (5), umbelliferone (6), 4-(3,4- dimethoxybenzyl)-3-(4-hydroxy-3-methoxybenzyl)-tetrahydrofuran-2-ol (7), daphnogitin (8), daphnetone (9), blumenol B (10), loliolide (11), 4'-hydroxyacetophenone (12), and 4'-hydroxybenzoic acid (13). Conclusion: Compounds 1-13 were all obtained for the first time from the plant of S. tianschanica and the genus Stelleropsis Pobed.

The situation of malaria and the evaluation of preventive measure for the Chinese medical team of United Nation peacekeeping mission deployed in Democratic Republic of Congo / 解放军医学杂志

Objective To clarify malaria infection and the incidence in first Chinese medical team of United Nation peacekeeping mission in Democratic Republic of Congo and evaluate the effect of prevention measures so that provide reference for studying on malaria prevention and the precautionary measures for the follow-up personnel in Africa. Methods 43 cases (male 30, female 13) were observed between Apr. and Dec. 2003 when they were deployed in D.R.of Congo. Eliminating mosquito was used to decrease the density, including the usage of driving mosquito machine, killing mosquito lamp and chlorine cyanogens chrysanthemum ester, ”Prevent malaria-3”and COTECXIN as the precautionary medicines. Plasmodiums in blood were checked periodically. The cases with positive result of blood test and without clinical symptom was considered as infection, otherwise as disease with symptom appeared. Results The density of mosquito in house decreased. 3 cases (male 2, female 1) suffering from malaria, the incidence was 6.98%. Plasmodium was found in 39 individuals (male 26, female 13), the infection rate was 90.70%. The incidence was the lowest compared with contingents from other countries. Conclusion It was effective that these measures taken by reducing mosquito density and ”Prevent malaria-3”and COTECXIN usage in Chinese medical team during peacekeeping mission .

Regulation of Na+ absorption and Cl- secretion in the endometrium: switching mechanisms

No abstract available.

Long-term toxicity of endostatin injection to Beagle dogs / 解放军医学杂志

Objective To evaluate the long-term toxicity of endostatin injection to Beagle dogs,and to provide safety evidence for clinical experiments.Methods Twenty-four pure-blood Beagle dogs were assigned to four groups averagely with six dogs for each group,and the sex ratio was 1∶1.The animals in three of four groups received endostatin injection at low(1.6mg/kg),medium(6.3mg/kg)and high(25.0mg/kg)dosage,respectively,and the animals in the other group acted as control.The Beagle dogs were injected intravenously daily for up to 3 months with the exception of the dogs in control group.The indicators of ordinary toxic response,weight,electrocardiogram and hematology were collected,and the blood biochemical analysis,routine urinalysis and histopathologic examination were also performed.Results Only ordinary toxic responses such as anorexia and laxness were observed from l dog in high dose group,and simultaneously disappeared in 4 days.The weight of all Beagle dogs studied increased in a normal rate.No significant difference was found in each group of dogs on heart rate,electrocardiogram and indicators of urinalysis.No evident changes were observed in dogs on hematological and biochemical indexes.The pathological chances in different levels were observed in a dog's liver of low dosage group and a dog's kidneys of blank control group,but such changes were regarded as the spontaneous pathological changes,not related to the application of endostatin injection.Conclusion The non-toxic dose of endostatin injection on Beagle dogs was estimated to be 6.3 mg/kg under the present conditions.